Plus-Hex CLINICAL
ABSTRACT Studies have identified higher mortality and morbidity rates among rabbits under anaesthesia compared with cats and dogs . Rabbits are increasing in popularity as pets , so it is important that veterinary nurses feel confident when anaesthetising these animals in practice .
This cross-sectional study surveyed 284 qualified RVNs working in the UK in 2019 , to identify the proportion of RVNs who lacked confidence in rabbit anaesthesia , highlight the reasons why , and elicit suggestions for changes to improve their confidence . The data obtained included the number of years qualified , training route , and confidence level in anaesthesia of cats , dogs and rabbits , along with other demographic data and relevant information about rabbit anaesthesia .
The results highlighted that confidence in rabbit anaesthesia was generally lower than for anaesthesia of cats or dogs . RVNs who trained through vocational training had greater confidence than those who trained through higher education , and 63.17 % of respondents suggested that more education about rabbit anaesthesia during initial training would increase confidence . Confidence in rabbit anaesthesia was reduced by a lack of experience in practice and negative opinions or stigma about rabbits . Moreover , RVNs who lacked confidence in airway management and emergency protocols in rabbits had significantly lower overall confidence in rabbit anaesthesia .
These findings suggest that educators could improve initial training about rabbit anaesthesia , especially in higher education . Students may need more handson experience with rabbits during their training , and more relevant continuing professional development courses could be made available .
Keywords anaesthesia , confidence , rabbit , Oryctolagus cuniculus , training
Introduction
Studies have identified higher mortality and morbidity rates under anaesthesia in rabbits compared with cats and dogs [ 1 , 2 ] . With the increasing popularity of rabbits as pets , the possibility that RVNs lack confidence when anaesthetising rabbits must be addressed , as RVNs often play a significant role in anaesthetic procedures in veterinary practice [ 3 ] .
Despite rabbits being the third most popular pet in the UK [ 4 ] , many veterinary professionals perceive them to be more challenging to treat than cats and dogs , with increased anaesthetic risks and complications [ 5 – 10 ] . It has been proposed that RVNs are apprehensive when treating rabbits because the number of cats and dogs seen in practice is much higher , and staff are unable to regularly practise rabbit-specific skills [ 11 ] . This proposition may be justified , as rabbits made up only 2 % of patients at 143 UK practices in 2017 , compared with much higher proportions of dogs ( 64.8 %) and cats ( 30.3 %) [ 12 ] . It was also hypothesised that RVNs do not feel confident placing intravenous catheters in rabbits , potentially reducing the choice of analgesic and anaesthetic drugs [ 11 ] .
Only 54 % of UK rabbit owners surveyed in 2019 had had their rabbits neutered , and 11 % said their rabbit was not neutered because they were worried about anaesthesia , compared with just 5 % of dog owners and 3 % of cat owners [ 13 ] . As rabbits continue to gain popularity , client expectations of the care provided during anaesthesia may increase [ 11 ] . Owners will demand the level of care that was once provided only to cats and dogs as the ‘ needs of the animal-owning public are not static , even though veterinary curricula may be ’ [ 14 ] . It has also been suggested that veterinary professionals do not receive enough education about rabbits [ 14 , 15 ] .
This anecdotal evidence and the authors ' experiences have highlighted a lack of confidence among RVNs when undertaking anaesthesia in rabbits , which is a concern as most anaesthesia in UK veterinary practices is performed by RVNs [ 3 , 8 ] . A study with a robust methodology and statistical analysis is therefore needed to establish whether these theories are correct .
Mortality and morbidity of anaesthetised rabbits
Three primary studies have been conducted into the mortality and morbidity of anaesthetised rabbits in the UK . During anaesthesias conducted in 1990 , the risk of death for rabbits was 3.57 %, compared with just 0.29 % for cats and 0.23 % for dogs [ 1 ] . A reduction in this risk was seen in 2008 , in a sample of 8,209 rabbits in which there was a mortality rate of 1.39 % [ 2 ] , likely reflecting the improvements in medication availability and surgical techniques over the preceding 20 years . Although improved , mortality remained higher than that of cats ( 0.24 %) and dogs ( 0.17 %) [ 2 ] .
A smaller sample of 210 rabbit anaesthetic records in 2018 identified a higher mortality rate of 4.8 %, and 38 % of the remaining patients developed non-fatal gastrointestinal complications , such as anorexia or decreased faecal output [ 16 ] . This higher risk may have been related to the smaller sample size or because patients were monitored for longer after surgery , increasing the opportunity to detect complications . Additionally , the 2018 study was conducted at a referral hospital , where populations with a higher risk of anaesthetic-related death are often treated [ 2 ] , whereas the previous two studies used anaesthetic records from primary care practices , where patients were likely to have had a good health status when presented for routine surgeries such as neutering , thus reducing their anaesthetic risk [ 17 ] .
Volume 39 ( 4 ) • August 2024
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